Vascular damage in patients with diabetes mellitus and smoking

Abstract

Background. Atherosclerosis is a progressive systemic disease associated with fatal cardiovascular (CV) complications. Diabetes mellitus (DM) and smoking are two major CV risk factors contributing to the onset of atherosclerotic disease. This study aims to identify which vascular territories are affected earlier. Objective(s). To compare the degree of carotid versus peripheral vascular damage in patients with DM and smoking history, in order to determine which vascular region is affected first. Materials and methods. The study included: Group I with DM (n=30) and Group II - smokers (n=30), aged 45-65 years (60% men, 40% women). The mean duration of DM was 9.4. The smoking index was 18. Diagnostic methods: Doppler ultrasound of the carotid, femoral and tibial arteries, assessment of intima-media thickness (IMT), degree of stenosis and presence of calcifications. Results. In Group I, vascular lesions were predominantly found in the lower limb arteries: 23% had intima-media thickness > 1.0 mm without stenosis, 40% had moderate stenosis (50-69%) and 37% had significant stenosis (>70%), with calcifications observed in 57% of patients. Significant carotid stenoses were detected in only 23% of the diabetes mellitus group. In Group II, carotid arteries were more frequently affected: 17% had intima-media thickness > 1.0 mm, 60% had moderate stenosis and 23% had significant stenosis, with calcifications present in 42% of cases. Significant lower limb stenoses were observed in 28% of smokers. Conclusion(s). In patients with diabetes mellitus, lower limb arteries tend to be affected earlier and more severely, whereas in smokers, the carotid arteries are more commonly involved. These distinctions may inform screening strategies and optimize the management of cardiovascular complications.